Editing Anatomy and Physiology – LPN Practice Questions (section)

==Question 6==
A licensed practical nurse is assisting a patient who had a stroke with the first meal after a swallow evaluation. Which observations should prompt the nurse to stop feeding and notify the registered nurse? '''Select all that apply.'''
# Coughing repeatedly after swallowing a sip of liquid.
# A wet or gurgling voice quality after swallowing.
# Food pocketing in the cheek on one side of the mouth.
# Taking about 25 minutes to finish the meal.
# Drooling and inability to keep the lips closed.

'''Answer:''' 1, 2, 3, and 5 (A, B, C, E).

''Rationale:'' Swallowing depends on cranial nerves that control the tongue, pharynx, and larynx. Coughing after swallowing, a wet or gurgling voice, food pocketing on one side, and drooling all suggest that these nerves are impaired and that food or liquid may be entering the airway, which risks aspiration pneumonia. Feeding should stop and the registered nurse should be notified. Option 4 is not by itself a danger sign; slower eating is common after a stroke, and the nurse should allow adequate time, keep the patient upright at 90 degrees, and have suction available.